1. Field of the Invention
The present invention relates to compositions and method of treatment for psoriasis and more particularly to the topical use of a tryptamine based drug that acts as a 5-hydroxytryptamine-1 inhibitor.
2. Related Art in the Field
Psoriasis is a widespread squamous skin disease and a chronic ailment affecting about 2-3% of worldwide population at a various extent. It presents as silvery scales on an erythematic base, especially on extensor surfaces, but it can affect as well the scalp, face, nails and flexors or intretigineous areas. Its presentation varies from confluent areas to pustular, guttate or annular. Skin symptoms may be either local or systemic, affecting the body as an acute, recurrent or chronic disease.
The pathophysiology of Psoriasis Vulgaris is immunologic and genetic (Gudjonsson J E et al; Schön and Boehncke). Skin lesions are considered to evolve due to a genetic tendency of the skin to react to internal hormonal stress and/or external environmental stress which cause an exacerbation (Nestle et al). A particular attention should be given to onset of psoriasis or its exacerbation due to post streptococcal infection which is generated by antigenic cross-reactivity between a surface antigen and human skin (McFadden et al). The pathological process of psoriasis involves a T lymphocyte infiltrate reaction in the epidermis and parakeratosis, and the disease is characterized as a T cell reactivity disease with disregulation.
Current treatment of Psoriasis Vulgaris is partially effective. Treatment involves chronic administration of drugs that might cause numerous undesirable side-effects due to safety issues of prolonged term administration of present treatments. For example, topical treatments using specific compounds might induce side effects, such as: steroids producing steroidal side effects; Vitamin D3 analogues—calcipotriol, low efficacy compound with irritant effect; Vitamin A derivatives, e.g. tazarotene, which are irritants and teratogenic; Immunologic agents—e.g. tacrolimus, pimecrolimus which might cause immunological suppression; local sensitisers such as Dithranol which can only be used for a short time due to irritation; and coal tar which is efficacious but with long term risk of tumors.
Systemic treatments which are currently in common dermatological use include: Phototherapy, such as UVB and PUVA which may induce potentially carcinogenic radiation; Cyclosporine A, known to cause severe immunologic side effects and tumors; Methotrexate which is an immunologic suppressant; Acitretin which is not only teratogenic but also an irritant potent cholesterol elevanting agent; Fumaric acid which causes a high incidence of gastro intestinal side effects; Purine manipulation using Mycophenolate, 6-thioguanine whch has not been shown to be effective and biological treatments which includes the administration of Alefacept, Efalizumab, or Infliximab which are not considered to be safe on the long range.
A mild subject suffering from Psoriasis Vulgaris is usually treated at the start by a steroid alone or in combination with calcipotriol. A subject suffering from a moderate condition may need the addition of one of the systemic agents or combined phototherapy, depending of the areas of involvement. Severe causes are generally treated by oral acitretin or phototherapy and by hospitalization.
A definitive, highly efficacious, fast acting and low side effects solution is lacking for the treatment of psoriasis. Hence, it is desired in the art to provide an effective treatment that overcomes the problems associated with current methods of treatment.